hypoglycemia

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Introduction

Also see Whipple's triad

Classification

Etiology

Epidemiology

Clinical manifestations

* syncope is NOT a manifestation

Diagnostic criteria

Laboratory

* do not use home glucometers to diagnose hypoglycemia[3]

Diagnostic procedures

Radiology

Complications

  • even mild hypoglycemia associated with increased mortality in critically ill patients
  • severe hypoglycemia is associated with increased risk of cardiovascular disease & death[6][12]

Differential diagnosis

Management

Comparative biology

More general terms

More specific terms

Additional terms

Component of

References

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  2. Jump up to: 2.0 2.1 Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998
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    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  4. Egi M et al Hypoglycemia and outcome in critically ill patients. Mayo Clin Proc 2010 Mar; 85:217. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20176928
  5. Neonatal hypoglycemia Maine Medical Center (MMC) http://www.mmc.org/mmc_bush/clinical_services_clinician_hypoglycemia.htm
  6. Jump up to: 6.0 6.1 Zoungas S et al, Severe Hypoglycemia and Risks of Vascular Events and Death N Engl J Med 2010; 363:1410-1418 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20925543 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1003795
  7. Jump up to: 7.0 7.1 ARUP Consult: Hyperinsulinemic Hypoglycemia The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/hyperinsulinemic-hypoglycemia
  8. Cryer PE. The barrier of hypoglycemia in diabetes. Diabetes. 2008 Dec;57(12):3169-76 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19033403
  9. Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Prolonged nocturnal hypoglycemia is common during 12 months of continuous glucose monitoring in children and adults with type 1 diabetes. Diabetes Care. 2010 May;33(5):1004-8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20200306
  10. Jump up to: 10.0 10.1 Greco D, Pisciotta M, Gambina F, Maggio F. Severe hypoglycaemia leading to hospital admission in type 2 diabetic patients aged 80 years or older. Exp Clin Endocrinol Diabetes. 2010 Apr;118(4):215-9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20072965
  11. Cryer PE, Axelrod L, Grossman AB, Heller SR Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009 Mar;94(3):709-28 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19088155
  12. Jump up to: 12.0 12.1 12.2 Lipska KJ et al HbA1c and Risk of Severe Hypoglycemia in Type 2 Diabetes. The Diabetes and Aging Study Diabetes Care. July 30, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23900589 <Internet> http://care.diabetesjournals.org/content/36/11/3535
    Goto A et al Severe hypoglycaemia and cardiovascular disease: systematic review and meta-analysis with bias analysis. BMJ 2013;347:f4533 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23900314 <Internet> http://www.bmj.com/content/347/bmj.f4533
  13. Jump up to: 13.0 13.1 Geller AI, Shehab N, Lovegrove MC et al. National estimates of insulin-related hypoglycemia and errors leading to emergency department visits and hospitalizations. JAMA Intern Med. 2014;174(5):678-686 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24615164
    Lee SJ So much insulin, so much hypoglycemia. JAMA Intern Med. 2014 May;174(5):686-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24614940
  14. Jump up to: 14.0 14.1 14.2 Lipska KJ, Ross JS, Wang Y et al. National trends in US hospital admissions for hyperglycemia and hypoglycemia among Medicare beneficiaries, 1999 to 2011. JAMA Intern Med. 2014;174(7):1116-1124 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24838229
  15. Jump up to: 15.0 15.1 15.2 Lauretti E, Li JG, Di Meco A, Pratico D. Glucose deficit triggers tau pathology and synaptic dysfunction in a tauopathy mouse model. Transl Psychiatry. 2017 Jan 31;7(1):e1020. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28140402 Free PMC Article
  16. Service FJ Hypoglycemic Disorders. N Engl J Med 1995; 332:1144-1152. April 27, 1995. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/7700289 <Internet> http://www.nejm.org/doi/full/10.1056/NEJM199504273321707
  17. Karter AJ, Warton EM, Lipska KJ et al, Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use. JAMA Intern Med. Published online August 21, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28828479 <Internet> http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2649265
  18. Cryer PE, Axelrod L, Grossman AB et al. Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2008 Dec 18; 94:709. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19088155
  19. Jump up to: 19.0 19.1 Zhong VW, Juhaeri J, Cole SR et al. Proximal HbA1C level and first hypoglycemia hospitalization in adults with incident type 2 diabetes. J Clin Endocrinol Metab 2019 Jun 1; 104:1989 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30608562 https://academic.oup.com/jcem/article-abstract/104/6/1989/5270382
  20. Jump up to: 20.0 20.1 20.2 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  21. Jump up to: 21.0 21.1 21.2 21.3 21.4 NEJM Knowledge+ Endocrinology
  22. Jump up to: 22.0 22.1 Wysham C, Bhargava A, Chaykin L et al Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 2 Diabetes. The SWITCH 2 Randomized Clinical Trial. JAMA. 2017;318(1):45-56. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28672317 <Internet> http://jamanetwork.com/journals/jama/article-abstract/2635630